Understanding addiction: the contributions of basic science
Experimental Psychology and Psychopharmacology have contributed to important advances in our understanding of addiction. I will discuss some of the recent successes and failures in this area. Firstly, an ever-expanding body of research on attentional bias for drug cues means that we now have a good understanding of its psychological mechanisms and clinical significance. However, progress on the development of attentional bias modification as a viable clinical intervention has been slow. Secondly, the related topic of automatic associations in addiction has led to the development and evaluation of approach tendency retraining as an adjunct treatment for alcohol dependence, and two trials conducted in Germany suggest that this intervention may be effective for the prevention of relapse. Third, I will talk about developments in impulse control in addiction, and will introduce ongoing research projects that evaluate the efficacy of computerised self-control training in problem drinkers.
I will then move on to discuss novel methods to facilitate extinction of responses to drug-related cues. Firstly, promising preclinical research on D-Cycloserine was hailed as an important advance in this area but recent studies with human participants have failed to justify the initial enthusiasm. Secondly, a memory retrieval-extinction procedure that was developed in preclinical research may be effective in human opiate users. Finally, recent experimental work suggests that it may be useful to consider drug-related cues as discriminative cues for instrumental responses (rather than Pavlovian cues), and target the development of new interventions accordingly.
Research funded by Medical Research Council, Economic and Social Research Council, Wellcome Trust, and Alcohol Research UK.